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BUSINESS OWNER/OPERAfOR IDENTIFICATION PAGE Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) 415 Erecti]o, <br /> OUNTVILLE AY <br /> If different from Site Address,otherwise leave blank Stt NoStreet Name Street Type <br /> NOTE: All official mail <br /> will go to this address OUNTVILLE CA 4599 <br /> City State ZIP <br /> BILLING ADDRESS (42) 16750 TATE HWY 88 <br /> If different from Mailing <br /> Address,otherwise leave blanko. Direction Street Name <br /> treet Street Type <br /> OCKEFORD CA 5237 <br /> City State ZIP <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ❑Single Owner ❑Partnership UNSTAFFED SITE O <br /> ORGANIZATION(43) ®Corporation ❑Public Agency NETWORK(44) <br /> ASSESSOR PARCEL NO.(45) <br /> 19-180-35 <br /> PROPERTY OWNER (46) PHONE NO.(47) <br /> NAME OSENTINO SIGNATURE 707-944-1220 <br /> (If different from Business Owner NTERPRISES,LTD. ,LLC <br /> PROPERTY OWNER (48) <br /> ADDRESS 415 HWY 29 <br /> Street Address <br /> OUNTVILLE 4599 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. F7 FIRE DISTRICT (49) <br /> NAME ICLEMENTS <br /> NEAREST CROSS (50) <br /> STREETISCHE RD. <br /> FACILITY (51) IF YES, HE FRONT POST ON A <br /> Locx Box ES WHERE IS IT LOCATED?(52> RELLIS ON NORTHWEST SIDE <br /> NATURE OF BUSINESS (53) <br /> INERY <br /> WASTE GENERATOR (54) O IF YES, <br /> WHAT IS YOUR EPA NO.?(55) /A <br /> TRADE SECRET (56) D SPILL PREVENTION (57) <br /> INFORMATION NO AND COUNTERMEASURES YES <br /> PLAN FOR THIS FACILITY <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (58) ES <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) <br /> names and signatures of employees trained,and names of instructor(s)? ES <br /> DATE REC'D: 3/20/08 <br />